Chart Notes & Insurance Claims
Posted on behalf of Rizk Law on Nov 30, 2009 in Insurance Issues
It’s not fair!! When it comes to claims, what happened in an accident matters less than what is documented…
Insurers are more accepting of injury claims which are well documented in medical chart notes. Why? Because real time documentation is strong evidence of what really happened and because insurers know folks are most truthful when speaking to their own doctors.
Consider this example: You are in an accident. Your back hurts very badly. Your head is pounding. Hoping to resolve your claim amicably, without first describing your symptoms to a medical provider, you honestly detail your pains to a claim examiner. The claims examiner seemed sympathetic. You are later shocked when claims presents you with a minuscule and insulting offer.
What went wrong?
- The insurer knows that because your symptoms were not explained to a doctor at or near the time of accident, you don’t have the medical documentation needed to eventually obtain a favorable outcome.
- Since you aren’t represented by an attorney, the insurer knows it will never have to answer to a jury or arbitrator. Without threat of litigation, insurers have little motivation to be reasonable.
What should you do?
- Seek medical treatment as soon as possible after an accident.
- Specifically and consistently describe all symptoms to your doctor or medical provider. Then, request he or she document your complaints in the chart notes.
- Ask for your medical records. They are yours, not your doctors.
- Review your medical records. If a doctor does not support your claim, you will want to know right away. Doctors rarely reveal unfavorable opinions to their patients while medical records accurately reveal a medical providers true feelings and opinions.
- If your medical provider does not support your legitimate claim, fire that medical provider. Favorable claim resolution is very difficult where a patient’s own doctor supports the insurer rather than you, the patient.